This Angel is pissed off. I'm Nurse Anne and I work on large general medical ward in the NHS. These are the wards with the most issues surrounding nursing care. The problems are mostly down to intentional understaffing by hospital chiefs that result in a lack of real nurses on the wards.
"The martyr sacrifices themselves entirely in vain. Or rather not in vain, for they merely make the selfish more selfish, the lazy more lazy and the narrow more narrow"-Florence Nightengale

Wednesday, 1 February 2012

Horrible things that Doctors do to Nurses

In my last post prior to this one I talked about my sincere respect for Junior Doctors and all they go through. And that wasn't bullshit. I do respect and admire them. But for the sake of balance let's talk about all the horrible things that doctors do to nurses. The number one thing that causes Registered Nurses to run away from the ward and frontline care is their Physician colleagues. Number one. Numero Uno. We don't hate cleaning up body fluids, or dealing with bedpans and death and dying. We don't mind washing patients, doing dressings or getting our hands dirty as well as all the skilled jobs that Nurses have to do. We leave the wards and healthcare in general because we want to get the hell away from Physicians. The junior ones are still pretty human towards the Nurses. They work hard, take a lot of crap and we respect them. But once they get past the level of "junior" I just want nothing to do with them. Not personally or professionally. Not anymore.

The abuse of Nurses by their medical colleagues is nothing new. Even Claire Raynor reported a surgeon throwing instruments at her decades ago. My godmother, an RN in the 1960's and 1970's, tried desperately to talk me out of Nursing school. "Doctors are mad at the world and it's the Nurses that they lash out at; you never want to work with one of these people" she told me. At that time I pictured my friendly family doctor and just laughed her off. I had only ever had experience with doctors as a patient. Working with these people is a whole different experience. The medical profession has a cruel streak and it is directed at Nurses. Always, always has been.

I don't even go to the doctor when I am sick. I try to tough it out unless I become convinced that I am going to die. He might find out that I am an RN. I told him that I am a homemaker, but he might find out that I am really a Nurse. Then he'll act like a creepy bastard towards me. It's no better with female doctors. They hate Nurses even more I think. The word is 'hate'. Make no mistake about it. And it has nothing to do with the bad nursing care on the wards (docs don't give a shit about nurse staffing), or the grumpy nurse who was mean to them when they were struggling students. Doctors need to decompress and registered nurses are not only an easy target but the only target. If they treated anyone the way they treated RNs they would probably be in jail.

I have seen many a Nurse fired for a physicians' mistakes. Too many to recollect all. Doctors are valuable and an RN is easy to blame and cheaper to sack. Doctors will lie through their teeth in order to pass the blame onto an RN. They lie about orders they gave or did not give. A lot. If a treatment goes bad they can pass the blame onto the scummy, incompetent Nurse. It's very, very easy for them to do.

As an NHS staff nurse I once had a new patient admitted to my ward. He has necrotic toes and was in agony. I looked on his drug chart and no pain medicine had been prescribed. I cannot give pain medication without a hospital doctor's order and approval from pharmacy. This is a time consuming process. I phoned the doctor on duty to get the order. His reply was "fuck off" and he hung up on me. I called him back. He told me to tell the patient to "deal with it" and hung up. I called him back at which time I got about 15 minutes of abuse and name calling. Then he refused to call me back. I finally got a doctor to prescribe for my patient. But that time the patient had been in agony for way too long. On the ward round the next day the abusive doctor says to the patient "You poor thing, your nurse never bothered to give you pain medicine, I will deal with her" and then he actually smirked at me. I've come to expect this kind of behaviour. If I told the patient what really happened I would lose my job.

Path lab once called me to tell me that my patient had a hgb of 7. I looked at yesterday's results. Yesterday her Hgb was 11. She was weak and short of breath. I took her obs and her blood pressure had dropped. My job in this situation is to look for signs of bleeding and notify the doctor of my findings. I called to notify the doctor of the critical lab value "I'm too busy for this crap, so just fuck right off" was the response I had from this patient's doctor. Then he hung up on me. Later on during the ward round the consultant wanted to know why a blood transfusion had not been prescribed yet. "The nurse never reported the low Hgb to me" replies the doctor who had hung up on me nearly 4 hours before. That got me a long lecture from the consultant explaining (yelling at me in the middle of the ward) to me why a sudden drop in hgb is something that needs to be reported to the attending doctor. Well, Duh. I did try.

Natalie was a nurse on my ward. She had a patient with a really complicated dressing change. The dressings that needed to be used were expensive and much more specialised than simple gauze. The damn things had to be ordered from pharmacy which is a mission itself. The patient had waited 5 hours for a dressing change by the time Natalie obtained the necessary materials. She set them up on a trolley and was on her way out of the treatment room and down the ward to the patient when a doctor saw her. He wanted a trolley for his notes and couldn't find one. So he grabbed the trolley from Natalie, dumped all of her materials onto the floor, did a little dance on them, piled his notes onto the trolley and walked down the ward. At that point pharmacy was out of the stuff and the patient had to wait days for more. Which of course got blamed on "lazy, neglectful Nurses'.

Report these Physicians at your own risk, Nurse.

I had a patient express a desire to have a sleeping tablet prescribed. I cannot prescribe, obviously, so I called the doctor on duty to get an order for something. "Tell her that this isn't a hotel" was the response of the doctor just before he hung up on me. Then he never returned my calls. The senior doctors above him consider it beneath them to take calls for this kind of stuff. She never got her sleeping tablet. The patient complained the next day about the Nurse not bothering to give her a sleeping tablet. The doctor told her that "no one had asked him". Liar.

When a doctor refuses to return our calls, hangs up, tells us to fuck off, insults that patient, lies etc etc we are not allowed to document it that way. We have to write " notified doctor of patient's request, awaiting orders". Not "doctor told me to to fuck off, that Gladys is a pain in the arse, and hung up on me". If the doctor lies and says "but the nurse never told me......" There is nothing that the Nurse can do. The doctor's word is the doctor's word. And that is the case even if their are other Nurse witnesses to his behaviour.

In a sudden emergency a doctor gave a strong verbal order to one of my Nurse colleagues. "Nurse give this patient 10 mg of dangerdrugacin" he shouted. The rule is that we are not allowed to give anything without a doctor's order in writing. But an emergency is an emergency and if you ask a doctor to write out an order in the middle of one he will rip your head off and kick it down the ward. The Nurse gave the drug that the doctor verbally ordered. The patient had a terrible reaction and died. The Nurse got fired. They had to blame someone to appease the family so they used the fact that the Nurse gave the drug "without a doctors order". As the doctor never put anything in writing, he was off the hook. Two other people heard the doctor give the order to the Nurse and said so. She still got fired.

I had a 30 stone patient admitted to my ward with respiratory distress. While I was admitting her I noticed that she had a stage 3 pressure ulcer on her sacrum. Her husband informed me that even though she can walk she refuses, and rarely moves at home. She sleeps, eats and does everything in her mobility scooter. I asked if she had been in hospital or under the care of nurses in the last year and he said no. The doctor came into see her. I told him that she had a pressure ulcer that looked infected. "Well that is the fault of the Nursing profession, you Nurses don't turn people" he shouts in front of the patient. I calmly informed him that the patient came into hospital with the ulcer. "Well it's still your fault" he says. At that point I asked the patient if she could stand up. She did so and asked her husband to bring her scooter up to the ward so that she could go out for a fag. When she was outside I asked the doctor if a pressure ulcer in a fully mobile patient who has not been in hospital under the care of Nurses was still the Nurse's fault. "Oh Fuck off, she has a pressure ulcer because she is a fat pig" he said. I then asked him why he told the patient and her husband that it was the fault of the nursing profession that she had a pressure ulcer. "Because I can" he said.

Doctor came to see the patient and told her that she could go home. Then he left the ward for 10 hours. He did not write her discharge orders or her drug prescriptions before he left. It took me 10 hours to get him back to the ward to do this. I am unable to discharge the patient without it. When I called him I was told "I'm busy, tell the patient to fuck off about her discharge" etc etc. When he finally came back to the ward the patient said to him "Doctor, you told me that I could go home this morning , why have the nurses made me sit here all this time". "Because the Nurses on this ward don't have it together" he told her.

How many times have doctors left orders for meds on the drug chart that should not have been there, only for the Nurse to get blamed when the drug was given? Seen that more times than I can count.

Nursing homes and social workers take 6 weeks to arrange a place for patients who need one. At least. The hospital nurse has no power over this. But that doesn't stop consultants for screaming at Nurses because "that patient is still here, don't you understand that she could get an infection because you fucking nurses didn't get her out of here, it is YOUR FAULT IF SHE DIES, YOUR FAULT". Usually this kind of stuff is said within ear shot of all the patients.

I once saw a doctor scream "You dirty pig" at a housekeeper (A HOUSEKEEPER) who dropped some cups on the floor. He then turned to the husband of a patient he was chatting with and said "We have to keep these dirty pig nurses in line or they would hand out the filthy cups that landed on the floor to the patients". The husband just nodded. The doctor knew that she was a housekeeper and that she was heading back towards the dishwasher with the cups. He was just being an asshole, because he can.

If a doctor forgets to order lasix cover between units of blood it is "the nurse's fault, because she should have reminded me". If a doctor order's something incorrectly "it is the Nurse's fault for not catching it".

If a doctor doesn't come and see a patient for hours and hours despite repeated calls from the Nursing staff it is also "the nurse's fault". If a ward nurse is forced by management to take care of 30 patients on her own, it is also her fault if the patients get neglected or an order gets missed, according to the doctors. If kitchen sends up the wrong food: doctor screams at the Nurse. CT department can't fit that scan in today: doctor screams at the Nurse. Social services delays nursing home placement: Doctor screams at the Nurse. Patient who has been ordered to be nil by mouth sneaks food behind the Nurse's back: Doctor screams at the Nurse. Patient refuses prescribed treatment or medication: Doctor screams at the Nurse. Pharmacy takes forever to dispense drug and refuses to stock the ward: Doctor screams at the Nurse. Patient decides to be noncomplaint with his fluid restriction nd renal diet and sneaks 10 litres of cherry fucking coke behind the Nurse's back: Doctor screams at the Nurse. You know damn well that neither can we watch your patients constantly nor get them to listen to us! Physio and OT avoid patient: Doctor screams at the Nurse. And he usually does this in front of patients to undermine the Nurse and make himself look like the hero.

Fuck this shit, Doctor. I am not a babysitter. I am not some self sacrificing angel who exists to take the fall for you. And neither am I a punching bag because your are frustrated with your job. Nurses CANNOT control your crazy, noncompliant patients, the allied health professionals, the waiting times in the GI department, nor pharmacy, nor social services nor blood bank nor relatives nor transport.

It's no better in the United States. The doctors here don't do shit. We Nurses have been told that if a doctor wants to prescribe a med that HE has to enter the order into the system. But he doesn't want to 99% of the time. He says "enter it yourself or your patient doesn't get it". And then he hangs up. If I enter it wrong or the patient has a bad reaction I will get the blame because I entered it. Or the doctor can say "I told her 2mg not 4 mg" even though he really did say "4 mg". They can basically change their order after the fact this way and pass the blame onto the Nurse. Thank god I only have 6 patients here. The doctors throw so many orders out at the Nurses but they refuse to enter them into the system. If I had 15+ patients like I do in the UK I would have to spend the entire day on the computer entering their orders for them. If the patient is actually going to get the treatment, the order has to be in the system. If the Nurse doesn't do it for them, and the patient doesn't get their treatment, the Nurse gets blamed. I can feel the eyes of the patients and relatives burning holes through the back of my head while I am on the computer. They probably think I am on facebook or something.

Oh my, I could go on for 100 pages with these kinds of stories. 100 pages easy. But you get the gist.

118 comments:

You raise a number of interesting points and in essence I agree with you 100%.I just make a point of charting every single comment and 'refusal to see and treat' the patient and times when the doctor was called...and I tell the patient-in fact i try and make any calls from my consulting room with the patient in the room....and if the doctor is getting snarky i put the call on speaker phoneI have also been told that I may not do this but counter with the argument that i am required by law to keep a contemporaneous record of patient care.And lets be honest there are ways of writing thing and using language that enables me and protects me....

Cripes! Mal Content is a noctor, alive and well and practitionering away in good ol'Blighty! So they - well, at least one - can be seen in the wild.

Note too, the use of the term consulting room. This is no false sighting; this is a real noctor.

Noctors aside, Dr No agrees that the medical profession has a dark streak of cruelty running through its heart, and a devious mind to apply that cruelty. But it's not only RNs who get it in the neck/heart/shin. Doctors who are perhaps more delicate flowers also get it, and so too do patients. And let us not forget that RNs (not to mention midwives - Dr No's first time on a labour ward was dominated by a sadistic goblin of an Irish midwife) can also be vile.

Dr No has for a long time wondered whether the caring professions act as magnets to not only those who do genuinely care, but also as compelling attractors to those who, perhaps subconsciously, see those professions as the perfect setting in which to practice their vile habits. One might even see parallels with certain members of, for example, the Catholic priesthood.

Good you're back. Most of the docs I've worked with have been brilliant. I have had a scalpel almost hit me. It was thrown by surgeon on to op table after having to put up with me as a green assistant. It bounced + just missed my face. I was angry back at him + would have sued if injured. The sister should have asked if it was ok for him to be saddled with such a greenhorn - she set the scene really. 2nd time a consultant had me thrown out of his consulting room because I couldn't read his writing and said his writing was atrocious.He did try to get me sacked which didn't work.Last one over doc cursing re patient's medical needs, just asked to repeat answer to request nswer + passed phone to patient as witness. Let me repeat most docs have been fab.Anna

I...wait what? I've never heard of stuff like this. Okay I'm a wet-behind-the-ears junior doctor but everyone with any sense has always told me to "TOE THE FREAKING LINE WITH THE NURSE if you want to live". Sure, I've seen doctors and nurses go at it, but usually the nurse comes out the better. Maybe it's because I come from a family of nurses, but I always at least thought reporting the doctor would get HIM in trouble and not you. I didn't think doctors were that powerful in medicine anymore.

And this line cracked me up "But once they get past the level of "junior" I just want nothing to do with them." OH WELL, I'm a junior doc for the next 2 years at least SO YOU'LL LOVE MOI (at least so long as you never meet me in real life. Cough).

Dr No:"Dr No's first time on a labour ward was dominated by a sadistic goblin of an Irish midwife"

HEAR FUCKING HEAR. Mine was Polish, but man do those midwives hate doctors.

Gosh over and over again I keep hearing that you guys are tortured by midwives!! What is their malfunction? One day you might be the guy their are fast bleeping when a labouring mother crashes.

You guys have to remember that a lot of my experience is stateside. Here the physicians bring money into the hospital. If they get mad at the hospital they will admit their patients somewhere else and the hospital loses a huge revenue stream.

Nurses are a cost to the hospital. The hospital just does not love us.

I get just as mad when I hear of Nurses and midwives abusing doctors. It should never happen. Ive stood up for Doctors when I saw this happen.

Over here we have one senior night shift doc at my new hospital who swings from being really abusive on the phone to Nurses when he is having a bad night to checking that we are okay and buying us pizza when he is having a good night.

Gosh over and over again I keep hearing that you guys are tortured by midwives!! What is their malfunction? One day you might be the guy their are fast bleeping when a labouring mother crashes.

You guys have to remember that a lot of my experience is stateside. Here the physicians bring money into the hospital. If they get mad at the hospital they will admit their patients somewhere else and the hospital loses a huge revenue stream.

Nurses are a cost to the hospital. The hospital just does not love us.

I get just as mad when I hear of Nurses and midwives abusing doctors. It should never happen. Ive stood up for Doctors when I saw this happen.

Over here we have one senior night shift doc at my new hospital who swings from being really abusive on the phone to Nurses when he is having a bad night to checking that we are okay and buying us pizza when he is having a good night.

Well I do believe that my trust was one of the worst. It supposedly was anyway.

The consultants used to regularly insult the nursing staff to the patients. They would tell them that their discharge was delayed because "the nurses can't be bothered to discharge you" when we were waiting on social services.

To my american readers : my ward did not have case managers. Nursing had to do all of that. So you were the only qualified nurse to 15 patients as well as unit secretary and case manager.

I wonder how much of the doctors' attitude resulted from just how often the ball was dropped because of poor nurse staffing. I don't think most of them understood how horrifically the RNs were struggling. They probably just thought we didn't give a fuck.

I have worked in a lot of hospitals and have never encountered events like those you describe. Yours must have been an exceptionally bad Trust.

Doctors and Nurses are like any other group of people. There are always a few who are arseholes. Those who cannot cope often seek to blame others. I know the nurses on our wards much better than the junior doctors. I have worked with them for years while the juniors change every few months.

Any doctor trying to pass the buck in such a way would almost always try similar antics with others. It is rarely just one persons word against another.

There is still very much a culture however among the older nurses that Dr's know best when in fact, in most cases, they know sweet-fuck-all about 5-10 of your patients because they are all either new admissions or the type of patients who only misbehave medically in the day when the bastard doctors you have to contend with are all working at night.

One night shift I had to ring the consultant intensivist on-call (at 3am) to urgently discuss 2 new patients we had on our cardiac surgical ward. Why? Because he was best at dealing with these patients ASAP as he had previously treated them in CITU and the fucktard of reg on-call who had told me personally an hour previous that he would come and see these patients for an urgent review, was a no-show and ignoring bleeps.

My mentor went fucking batshit, NOT for the fact that the reg on-call did not turn up, NOT for the fact that these patients had been dumped on us 2 days post-op (when we only took 4 or 5 days post-op) or NOT for the fact the lab took 4 hours to get urgent results back to us on-screen.

No, she went nuts because I had "disturbed" the consultant on-call.

Are you serious? One, I was not prepared for these patients to fall critically ill because of some phantom registrar, or slow lab tech. Two, we were not capable of dealing with that kind of situation where the patients become critical or crash anyway, as the other Nurse on shift with us had to deal with her ill patients, and we had a HCA who didn't know shit from clay. And finally, the consultant is NOT PAID TO SLEEP OR NOT BE DISTURBED. He is paid and displayed for this kind of situation.

The consultant was happy enough to come up, review and sort our ill patients out. He knew these patients from CITU so all was well. Disaster averted. He then went in our ward office and gave our reg on-call an earful, when he had eventually turned up that is, and was like a deer caught in the headlights when he spotted a consultant on the ward.

Me and my Mentor hashed things out later on. I'm sure she still thinks to this day I was in the wrong, if I was a betting woman, I would of place bets on kidney failure and possible arrest in our patients had I not bit the bullet and called that doctor. Deep down I'm sure she was just embarrassed that our night team are just so incompetent.

Kitty do you by any chance work on a short staffed acute medical floor?

The patients on this kind of floor are way to sick to be there....these patients would have been in ICU 10 years ago.

Yet the RN numbers on these floors have been decreased over the last 10 years rather than increased to stay in line with skyrocketing acuity.

The ball is constantly getting dropped as a result. The poor care that occurs as a result of this leads to the RNs getting a bad reputation and talked to like dirt. Nurses who work in traditional specialty areas like ICU, outpatients, CCU and ED do not have these same problems because they are better resourced with less (or just different) chaos.

Doctors pass the blame, take out their frustration, and disrespect general acute medical floor RNs regularly. But they would never do the same thing to ITU RNs who have less fuck ups because of better ratios and resourcing.

One of my old colleagues on my NHS floor in england went to ICU and she has informed me how "nice" and "supportive" the doctors are there. Sometimes these are the same doctors who had patients on our old medical floor and wiped the floor with us.

This made me sick to my stomach. I'm a medical student, and the thought of working with this kind of people makes me physically ill.

For all of you nurses: if you ever in the future works with a mousy-haired, 160 cm, blueeyed slightly cynical norwegian girl (that can be a mean bitch when tired, but tries really hard not to), that acts this way, please:A: Hit me somewere it hurts. Hard.B: Admit me to psych for a personality disorder.

(And we are told repeatedly at the wards: Be nice to nurses and the staff, they rule the universe and can and will make your life a living hell if you're an ass.)

Whoa... if nurses are treated like that, I now know why some are so needlessly awful to me and why others act like I'm some kind of angel if I make them a cup of tea and smile and say "of course" when they ask me to write up some pain relief.

No Anne, I have to confess that I work in acute psychiatry. Very busy and at times very dangerous. Consultants are only seen at ward round and Juniors passing through accept that asking for an urgent 10 + 2, avoids the staff clogging up A+E.

Whilst I wish I could say "As if that stuff happens, Nurse Anne you just have a chip on your shoulder" Unfortunately I can see everyone of those examples being possible. Well in the UK at least, not where I work now.

On a positive note, I really think that this is a severe narrow end of a wedge and a lot more interactions are positive.

With regards to dark streaks, they are not inherent to all doctors, but I know that they can develop when exposed to shit for a long enough period of time.

I know for a fact I'm less of a grumpy bastard now I don't work in such a "clusterfuck". It's also a 2 way street a clusterfuck for a Dr is a clusterfuck for a nurse and such aggro is inevitable.

Why do doctors leave written orders to call if a patient develops a temp of 102+ etc etc etc and then get nasty over the fact that you called. They know damn well that the Nurse cannot herself order those things but that she will get it in the neck if she doesn't notify a physician and get orders for something.

Over here the doctors put in standing orders for the Nurses to order and obtain blood cultures for a high temp if appropriate. Or they prescribe PRN IV lopressor for severe tachycardia along with parameters....stuff like that so that they can avoid the pages and phone calls from their patients' Nurse.

Nurses feel like they are just thrown to the sharks by the physicians. You don't communicate with your patients and then we get it in the neck. Or you don't prescribe what the patient wants and again, it is the Nurse who the patient gets mad at. Or you prescribe something that is too time consuming for a ward nurse with 15 patients to handle without neglecting her other patients. Then she gets accused of poor Nursing and neglect.

You don't spend anytime with these people and don't know what they are like. Everytime you prescribe meds for midnight and order hourly vitals you can rest assured that your patient is abusing the Nurse because she "woke me up" rather than being grateful that they are getting 21st century healthcare.

One thing I always wished is that doctors would say this to patients on admission "I will have to order meds at night, your IV bag may need to be changed at night, I often have to order vital signs at night etc etc etc. The Nurse has NO choice about disturbing you overnight". Wake them up to give them that midnight dose of tazocin and they rip our fucking heads off.

Or how about "I stopped your digoxin tablet that you take everyday because the level of digoxin in your blood is too high, which has caused you to be ill and come into hospital." that might help avoid the Nurse getting 10 phone calls an hour from irate relatives because mum "isn't getting her heart tablet from those lazy nurses". The nurse of course told the patient why she is not getting her digoxin but the patient is old and can't made sense of it and calls her family to complain that the Nurse "hasn't bothered to bring her the daily pill that the GP prescribed and told her to take daily for her heart."

So much of a ward Nurse's time gets eaten up with this shit. relatives ringing because they "don't know what is going on" or they want to know the result of mum's scan etc etc. We can't tell them that but it doesn't stop them from calling and wasting our time..... probably 40 minutes out of every hour.

If you order an insulin drip for one patient you stop his Nurse from being able to manage her other patients. Insulin drips are time consuming and should not be on a general ward where there is one nurse to 15 patients. Same with cardiac drips. You order a blood transfusion and that takes me away from my other patients for hours. Then they tear me apart over their neglect.

Obviously you have to order these things to do your job but just be aware, you are throwing the Nurse to the sharks every single time you do it. And in a childish way it makes us seethe with resentment. Especially if you are not communicating with patients. That just adds to the hell.

If you guys actually communicated with your patients, bedside Nursing might be slightly easier to tolerate. But you are never there, you don't explain things to patients, you order stuff we can't handle on the wards because it is to time consuming, and then the Nurse is made to suffer for that. Constantly.

We Nurses think that they should be a doctor on every ward. But that would mean actually having to deal with your crazy and pissed off patients huh?

If nurses have a chip their shoulder it is because of this kind of stuff, not jealousy over status,class or pay.

I agree and sympathize with many of the comments above. The doctors I worked with frequently did not know how to do what they ordered done for their patients. That created heated discussions that did not help the patients or the staff.

Indeed, I have found some junior medical colleagues damn right obstructive and generally difficult, they tend to change with a) experience and of course b) when they need an ECG or bloods doing! I always bear this in mind that they usually need us and rely quite heavily on us! Luke RichardsonNurse Practitioner

Nurses that I've worked with will go out of their way to mess with you so they can show how big their egos are. I've had nurses "quote" hospital policies to try to make sure that they get their way. When I asked to be shown these policies, the usual response is to huff-and-puff and walk away.

Nurses will SHIT on anybody who is not the attending so that they can feel important. Poor clerks, housestaff, med students, nursing students have ALL felt this wrath.

Nurses will badger you at 3AM incessantly regardless of what you are doing (in the middle of a procedure) and won't take "later" or "no" for an answer. I've seen nurses beep and beep and beep a Trauma Resident repeatedly while they were in the middle of an emergency surgery just because their patient wanted medicine to help them sleep. Most physicians are more professional than to stoop as low but I'm not surprised that some nurses are eventually told to fuck off.

Furthermore, most nurses do not understand the pathophysiology behind any given condition or why a specific medication is prescribed or when it cannot be used. They see an order in a chart and make it their sole life mission to no-questions-asked make sure that every single thing is fulfilled regardless of whether or not the physician tells them that the plan is in the process of being altered. Almost robotic.

On the other hand, I've met nurses that are sweet, caring, helpful and essential members of the medical team whose only concern is the well-being of the patient. Unfortunately, they have been few and far between.

I agree and sympathize with many of the comments above. The doctors I worked with frequently did not know how to do what they ordered done for their patients. That created heated discussions that did not help the patients or the staff. When I retired, I looked for a job tht did not involve doctors.

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I'm a resident doctor and I'll straight say: very few nurse treat me respect. I don't buy your load of 'sincere' care about my wellbeing for a minute. Sorry.

I've been called a 'fucking douche bag' for ordering a lactate that required an additional blood draw and ice. I've been called 'the most unprofessional doctor' because I wouldn't share confidential information about a patient in the ED with a nurse.

Nurses have done a good job of making this doctor be very wary and distrustful. It started in medical school where (and I trained at the top top school in the US) nurses berated us and made life a living hell. Oh, and residency hasn't proved much better (and I've rotated through 3 hospitals). Nurses promote 'disruptive physician' propaganda even though that's the 3% of asshole docs. How many nurses realistically could be written up for disrespecting residents and med studs?

YOU get no quarter with me. I write nurses up for everything appropriate and give no quarter to someone not willing to do it EXACTLY as ordered. And I love busting you all on HIPPA. Watch it I'm the little fella in the elevator taking down your name badges and costing you your job.

Bitter much ? Hell yes - and it's not because of doctors - it's because of nurses.

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I am nursing student in Poland. Doctors feel like Gods also in Poland, however we dont have so dramatic cases here! if any doctor would act this way (like destroying expensive dressing) he would be scold at least.. I dont understand why nurses are helpless and cant complain. Because they dont raise their voice, they are so much mistreated there

I think this post is quite exaggerated. I know physicians are busy and can be inpatient. If it were me I would have went to the administration and director of nursing for verbal abuse. No way would I take that.

This is dreadful. No nurse doing her or his duty to help a patient should be treated this way by a doctor. I say TAPE RECORD THE PHONE Call to the doctor, so you get his/her response on RECORD...then send it to the NEWS media.....this will be a real wake up call to arrogant LYING DOCTORS......

In an atmosphere if universal deceit telling the truth is a revolutionary act. George Orwell.

Why has Nursing Care Deteriorated

Good nurses are failing every day to provide their patients with a decent standard of care. You want to know what has happened? Read this book and understand that similiar things have happened in the UK. Similiar causes, similiar consequences. And remember this. The failings in care have nothing to do with educated nurses or nurses who don't care. We need more well educated nurses on the wards rather than intentional short staffing by management.

About Me

I am a university educated registered nurse. We had a hell of a lot of hands on practice as well as our academic courses. The only people who say that you don't need a brain or an education to be an RN are the people who do not have any direct experience of nursing in acute care on today's wards. I have yet to meet a nurse who thinks that she is above providing basic care. I work with nurses who are completely unable to provide basic care due to ward conditions.
I have lived and worked in 3 countries and have seen more similarities than differences. I have been a qualified nurse for nearly 15 years. I never used to use foul language until working on the wards got to me. It's a mess everywhere, not just the NHS.
Hospital management is slashing the numbers of staff on the ward whilst filling us up with more patients than we can handle... patients who are increasingly frail. After an 8-14 hour shift without stopping once we have still barely scratched the surface of being able to do what we need to do for our patients.

Quotes of Interest. Education of Nurses.

Hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. Our findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients."...Journal of advanced nursing 2007

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level.

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania's Center for Health Outcomes and Policy Research found that patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses are providing direct patient care.

Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 - one by the state of New York and one by the state of Texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level.

Registered Nurse Staffing Ratios

International Council of Nurses Fact Sheet:

In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.

A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)

Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.

Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications

•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)

Disclaimer

I know I swear too much. I am truly very sorry if you are offended. Please do not visit my blog if foul language upsets you. I want to help people. That is why I started this blog and that is why I became a Nurse. I won't run away from Nursing just yet. I want to stick around and make things better. I don't want the nurses caring for me when I am sick working in the same conditions that I am. Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.